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General NPI Number Information
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NPI Number | 1548883200
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Entity Type | Individual
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Provider Name | EMILY MCDERMOTT DPT
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Gender | Female
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 3688 VETERANS MEMORIAL DR
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City | HATTIESBURG
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State | MS
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Zip | 39401-8246
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Country | US
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Telephone | 601-554-7566
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Fax |
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Provider Business Mailing Address
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Address Line | 28 BRIDGEFIELD CT
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City | HATTIESBURG
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State | MS
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Zip | 39402-8690
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Country | US
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Telephone | 228-860-3324
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT6877
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License Number State | MS
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